[Jeff Higgins]

Scott, I asked the same question of my surgeon - why not some form of a "captured" ball and cup? He told me that they do, in fact, offer that solution, but only as a very last resort. He said something like "hey, you're an engineer. Let's talk failure modes. Would you rather have the ball lever itself out of the cup in such a fashion as to allow for a non-surgical reinsertion, or would you rather it rip the glue joint loose that holds the cup into your pelvic bone?" Pretty easy choice, really.

Zeke, I quite literally "feel your pain". Between my wife and I in this year alone we have had two OR stays, first to remove a cyst the size of an eight ball from one of her ovaries, and then this right hip modification for me. On top of that I have had three ER visits to pop my hip back in place, wherein they fully sedate before even trying this procedure. I'm told (by my wife) that it's quite violent. My fourth dislocation did not require transport to hospital, I'm told it was not actually all the way out.

In each and every case the pain management protocols followed by both the EMT crews and the hospital staffs were not just "inadequate", they were borderline criminally abusive. My wife had to be held overnight after having been cleared for discharge, intending to pick up pain medication from the hospital pharmacy on our way out. Well, that pharmacy closed before we could do that, so I suggested that the "care team" simply supply enough to get her through the night until I could make it to our pharmacy in the morning. Well, by golly, they "couldn't do that". So we agreed to leave her in their care overnight. Except... they still could not dispense any pain meds. They had none on hand outside of their closed pharmacy. In a hospital, for God's sake. So she spent the entire night in post op with nothing more than Tylenol, me sleeping in the chair next to her bed.

In my three trips to the ER with my dislocated hip, I was never offered anything for the pain. Hell, the second trip required driving the ambulance across a motocross track, with me in the back, to retrieve me. Average amount of time across three ER visits before they gave me anything for pain was about two hours.

This last trip to the OR (for my hip) saw me on a four hour schedule for post op pain meds. I never went less than six hours between doses. Lots of apologies, blah blah blah, but there I was. Upon discharge, they sent me home with meds (filled in the afternoon at their in hospital pharmacy), just enough for that night and the next day. They told me to contact my surgeon's office and he would fill to get me through the weekend, which would have been great, but...

This was getting late-ish on Thursday afternoon, and like I presume most surgeons, he does not hold weekend hours. So I called him first thing Friday morning, we agreed that the math shows me running out in the middle of the night on Sunday, so yes, absolutely, he called it in to my pharmacy. Thought we were good to go... The pharm app said we were...

Until it didn't, which turned out to be Saturday morning. So I called the pharmacy. They told me that my insurance (damn good insurance, by the way, negotiated for me as a retired Boeing engineer) would not allow a refill until Monday, due to something in their opioid protocols. I was free to call my surgeon and have him dispute this with the pharmacy and/or insurance provider, of course, but as explained earlier, this was now Saturday. No one in that office until Monday. So I told the pharmacy that I would simply pay out of pocket. They told me that they couldn't do that, I told them they had a prescription in hand, and I was just two days post op on a hip replacement. So the pharmacy relented, took pity on me, or whatever, and I finally got a refill late Sunday afternoon.

So, yeah, at risk of "PARFing up" my own thread, this whole pain management thing has gotten way, way out of hand. Everyone is terrified of the scrutiny applied when they prescribe opiate pain meds. I don't blame them, their very careers and livelihoods are at risk, under the watchful eyes of state and federal bureaucrats enforcing arbitrarily mandated limits. We know how to treat pain. We have for a very long time. It's time to stop pretending that OR and ER patients, who have suffered traumatic injury, are fueling this "opioid crisis". They simply are not. But, well, I guess it's easier to pick on productive, middle aged folks who have been unfortunate enough to find themselves hospitalized than it is to face the music and go after the real progenitors of this problem. And all the while people like your wife, my wife, myself, and countless others suffer some pretty severe pain, and threaten to crawl out of the ER in hopes of finding better, more urgent care. I actually said a similar thing to the staff during one of my own resent stays in the ER. It didn't have to come to this. This is absolutely unacceptable.